Same-Day Surgery Isn’t Just a Clinical Innovation, it’s a System Strategy at Lakeridge Health

Hospitals are caring for older, more complex patients at a time when surgical volumes continue to grow and health systems across Ontario and beyond face persistent capacity and resource constraints. 

At the same time, evidence increasingly shows that for appropriately selected patients, prolonged hospitalization after many procedures is not clinically necessary. 

This is the context in which same-day surgery is evolving. Not long ago, a hip or knee replacement routinely meant several days in hospital. Today at Lakeridge Health, more than half of joint replacement patients are discharged home the same day. 

This shift reflects a clinically led redesign of surgical pathways – grounded in careful patient selection, interdisciplinary alignment, and structured post-discharge support. 

Redesigning the Pathway, Not Just the Procedure 

Minimally invasive techniques alone do not enable same-day discharge. What makes it possible is coordination across the entire perioperative journey. 

Across Lakeridge Health’s broad integrated system of care, including at Ajax Pickering, Bowmanville,  Oshawa, and Port Perry Hospitals, and at the state-of-the-art surgical centre within the Jerry Coughlan Health & Wellness Centre, Lakeridge Health has expanded same-day pathways for procedures including hernia repair, hysterectomy, anterior cruciate ligament (ACL) reconstruction, cataract surgery, and total hip and knee replacement. 

This progress required more than adopting minimally invasive techniques. It demanded coordinated redesign through standardized perioperative pathways, early mobilization protocols, strong patient education, and remote care monitoring. 

Implementation required strong collaboration across surgical, anesthesia, nursing, and rehabilitation teams, including: 

Same-day discharge is not appropriate for every patient. The emphasis remains on selecting the right candidates and ensuring appropriate safeguards are in place. 

Maintaining Safety Beyond the Hospital Walls 

Patients discharged after same-day surgery are supported through the Remote Home Care Monitoring Program, which provides structured virtual follow-up through mobile health applications and scheduled nurse check-ins. 

Continuous monitoring enables early identification of complications and timely intervention. The objective is not shorter stays alone, but safe recovery in the most appropriate setting. For many patients, recovering at home supports earlier mobilization and reduces exposure to hospital-acquired complications. 

In 2024-25, 20 per cent of total hip and knee replacement patients at Lakeridge Health were discharged the same day. Today, that number has risen to 50 per cent, achieved while maintaining clinical safety standards.  

Where inpatient stays have historically been routine, clinical teams now have the opportunity to reassess necessity. With the right elements in place, same-day surgery can enhance patient experience and preserve inpatient capacity for those who truly require it. 

Questions for Clinical Leaders 

The broader lesson is this: surgical innovation is not only technical. It is operational. 

Health systems across Canada face growing aging populations, infrastructure constraints, and limited ability to add beds. Expanding physical footprint is rarely the fastest solution. Redesigning care pathways often is. 

For leaders considering similar shifts, key questions include: 

Same-day surgery is not about speed. It is about appropriateness. The right patient, the right pathway, and the right supports. 

When implemented thoughtfully, it improves patient experience, strengthens hospital flow, and increases access without expanding infrastructure. The future of surgery will not be defined solely by what happens in the operating room. It will be defined by how effectively we design the system around it.